Physical Therapy Treatment for Lower Back Pain During Squats and Deadlifts
In today's episode we go over Physical Therapy Treatment for Lower Back Pain During Squats and Deadlifts:
- 0:00 Intro
- 2:04 Why are squats and deadlifts so relevant with lower back pain?
- 3:40 Is weight training dangerous? What does the literature say?
- 5:00 Does lower back pain improve over time?
- 7:46 When is lower back pain an emergency? Medical red flags
- 9:34 What causes lower back pain during squats and deadlifts?
- 18:43 What are the most common lower back injuries from squatting and deadlifting?
- 21:50 Should I continue to squat and deadlift with lower back pain?
- 24:02 4 steps to fixing lower back pain during squats and deadlifts?
- 31:20 How to modify squats and deadlifts with lower back pain in the gym
- 35:06 Understanding exercise prescription for lower back rehabilitation
- 40:51 How to modify the olympic lifts with lower back pain (clean and jerk, snatch)
- 44:44 How to use blood flow restriction training (BFR) for lower back pain
- 46:45 How to identify and correct mobility limitations that can create lower back pain
- 49:44 How to correct technique issues in squats, deadlifts and olympic lifts with lower back pain
- 52:54 How to apply a progressive physical therapy treatment program for lower back pain during squats and deadlifts
- 54:43 The Best Physical Therapy Exercises for Lower Back Pain During Squats and Deadlifts
- 1:03:07 Sample physical therapy program for lower back pain during squats
Listen and Subscribe to the Podcast
You can listen to the podcast and subscribe with any of the links below.
Show Notes / Relevant Articles:
- FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
- The Ultimate Guide to Getting Out of Lower Back Pain and Back to Squatting, Deadlifting and Olympic Lifts - With Modification Infographics
- The Best Exercises To Get Out of Lower Back Pain and Back to Training
- 6 Causes of Extension Based Low Back Pain in the Gym
- How Dangerous is CrossFit Really? - Injury statistics for fitness
Want to support me and decide topics for future episodes? Click HERE to sign up for FPF "Insiders" for just a dollar. You'll gain access to 100+ webinars, e-books and complete guides. Plus, you'll get private access to the "Insiders" Facebook group where you can have all of your questions answered by me.
Looking for other ways to support me that are 100% free?
- Like, comment and share on youtube, facebook and instagram
- Leave a 5-star review on apple podcasts
Dan Pope DPT, OCS, CSCS
Oliveira, C. B., Maher, C. G., Pinto, R. Z., Traeger, A. C., Lin, C.-W. C., Chenot, J.-F., … Koes, B. W. (2018). Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. European Spine Journal.
Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., … Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1–A57.
Shiri, R., Coggon, D., & Falah-Hassani, K. (2017). Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials. American Journal of Epidemiology, 187(5), 1093–1101.
Welch, N., Moran, K., Antony, J., Richter, C., Marshall, B., Coyle, J., … Franklyn-Miller, A. (2015). The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport & Exercise Medicine, 1(1), e000050–e000050. doi:10.1136/bmjsem-2015-000050
Winwood, P. W., Hume, P. A., Cronin, J. B., & Keogh, J. W. L. (2014). Retrospective Injury Epidemiology of Strongman Athletes. Journal of Strength and Conditioning Research, 28(1), 28–42.
Strömbäck, E., Aasa, U., Gilenstam, K., & Berglund, L. (2018). Prevalence and Consequences of Injuries in Powerlifting: A Cross-sectional Study. Orthopaedic Journal of Sports Medicine, 6(5), 232596711877101.
Keogh, J. W. L., & Winwood, P. W. (2016). The Epidemiology of Injuries Across the Weight-Training Sports. Sports Medicine, 47(3), 479–501. doi:10.1007/s40279-016-0575-0
The Development and Application of an Injury Prediction Model for Noncontact, Soft-Tissue Injuries in Elite Collision Sport Athletes. (n.d.). Retrieved August 01, 2016, from https://www.researchgate.net/publication/46288877_The_Development_and_Application_of_an_Injury_Prediction_Model_for_Noncontact_Soft-Tissue_Injuries_in_Elite_Collision_Sport_Athletes
Relationship Between Training Load and Injury in Professional Rugby League https://www.researchgate.net/profile/Tim_Gabbett/publication/49775412_Relationship_between_training_load_and_injury_in_professional_rugby_league_players/links/551894590cf2d70ee27b41ad.pdf
Training and game loads and injury risk in elite Australian footballers. (n.d.). Retrieved from https://www.researchgate.net/profile/Brent_Rogalski/publication/234699103_Training_and_game_loads_and_injury_risk_in_elite_Australian_footballers/links/53dadd6b0cf2a19eee8b3f9f.pdf
A 4-Year Analysis of the Incidence of Injuries Among CrossFit-Trained Participants Orthop J Sports Med. 2018 Oct; 6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201188/
Injury Incidence and Patterns Among Dutch CrossFit Athletes Orthop J Sports Med. 2017 Dec; 5(12): 2325967117745263. Published online 2017 Dec 18. doi: 10.1177/2325967117745263 Mirwais Mehrab, BSc,*† Robert-Jan de Vos, MD, PhD,‡ Gerald A. Kraan, MD, PhD,† and Nina M.C. Mathijssen, PhD†
Injury Rate and Patterns Among CrossFit Athletes Orthop J Sports Med. 2014 Apr; 2(4): 2325967114531177. Benjamin M. Weisenthal, BA,* Christopher A. Beck, MA, PhD,† Michael D. Maloney, MD,‡ Kenneth E. DeHaven, MD,‡ and Brian D. Giordano, MD‡§
INJURY RISK IS ALTERED BY PREVIOUS INJURY: A SYSTEMATIC REVIEW OF THE LITERATURE AND PRESENTATION OF CAUSATIVE NEUROMUSCULAR FACTORS Int J Sports Phys Ther. 2014 Oct; 9(5): 583–595. Jessica Fulton, PT, DPT, HFS,1 Kathryn Wright, PT, DPT,1 Margaret Kelly, PT, DPT, CSCS,1 Britanee Zebrosky, PT, DPT, CSCS,1 Matthew Zanis, PT, DPT, ATC, CSCS,1 Corey Drvol, PT, DPT,1 and Robert Butler, PT, PhD1
Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014 Mar;34(2):129-33. Milewski MD1, Skaggs DL, Bishop GA, Pace JL, Ibrahim DA, Wren TA, Barzdukas A.
Therapeutic Neuroscience Education Louw 2013
Schoenfeld, B. J. (2010). Squatting Kinematics and Kinetics and Their Application to Exercise Performance. Journal of Strength and Conditioning Research, 24(12), 3497–3506.
Saraceni, N., Kent, P., Ng, L., Campbell, A., Straker, L., & O’Sullivan, P. (2019). To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-Analysis. Journal of Orthopaedic & Sports Physical Therapy, 1–50.
Nolan, D., O’Sullivan, K., Newton, C., Singh, G., & Smith, B. E. (2019). Are there differences in lifting technique between those with and without low back pain? A systematic review. Scandinavian Journal of Pain, 0(0).
Mechanotransduction: Relevance to Physical Therapist Practice-Understanding Our Ability to Affect Genetic Expression Through Mechanical Forces. Phys Ther. 2016 May;96(5):712-21. doi:
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J., Tagliaferri, S. D., Brisby, H., … Belavy, D. L. (2019). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, bjsports–2019–100886.
Lee, J.-S., & Kang, S.-J. (2016). The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. Journal of Exercise Rehabilitation, 12(5), 463–470.
Aasa, B., Berglund, L., Michaelson, P., & Aasa, U. (2015). Individualized Low-Load Motor Control Exercises and Education Versus a High-Load Lifting Exercise and Education to Improve Activity, Pain Intensity, and Physical Performance in Patients With Low Back Pain: A Randomized Controlled Trial. Journal of Orthopaedic & Sports Physical Therapy, 45(2), 77–85.
Berglund, L., Aasa, B., Michaelson, P., & Aasa, U. (2017). Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness. SPINE, 42(15), E876–E882
Berglund, L., Aasa, B., Hellqvist, J., Michaelson, P., & Aasa, U. (2015). Which Patients With Low Back Pain Benefit From Deadlift Training? Journal of Strength and Conditioning Research, 29(7), 1803–1811.
Steffens, D., Maher, C. G., Pereira, L. S. M., Stevens, M. L., Oliveira, V. C., Chapple, M., … Hancock, M. J. (2016). Prevention of Low Back Pain. JAMA Internal Medicine, 176(2), 199.
Matthew Whalan, Ric Lovell & John A Sampson (2020) Do Niggles Matter? - Increased injury risk following physical complaints in football (soccer), Science and Medicine in Football, 4:3, 216-224, DOI: 10.1080/24733938.2019.1705996
Fares MY, Fares J, Salhab HA, Khachfe HH, Bdeir A, Fares Y. Low Back Pain Among Weightlifting Adolescents and Young Adults. Cureus. 2020;12(7):e9127. Published 2020 Jul 11. doi:10.7759/cureus.9127
Siewe, J.; Rudat, J.; Röllinghoff, M.; Schlegel, U. J.; Eysel, P.; Michael, J. W.-P. (2011). Injuries and Overuse Syndromes in Powerlifting. International Journal of Sports Medicine, 32(9), 703–711. doi:10.1055/s-0031-1277207
Low Back Disorders - Stuart McGill
Coulombe BJ, Games KE, Neil ER, Eberman LE. Core Stability Exercise Versus General Exercise for Chronic Low Back Pain. J Athl Train. 2017 Jan;52(1):71-72. doi: 10.4085/1062-6050-51.11.16. Epub 2016 Nov 16. PMID: 27849389; PMCID: PMC5293521.
Stevens S, Agten A, Timmermans A, Vandenabeele F. Unilateral changes of the multifidus in persons with lumbar disc herniation: a systematic review and meta-analysis. Spine J. 2020 Oct;20(10):1573-1585. doi: 10.1016/j.spinee.2020.04.007. Epub 2020 Apr 20. PMID: 32325246.
- Image: Disc Herniation - https://commons.wikimedia.org/wiki/File:Lagehernia.png Attribution: Mjorter at Dutch Wikipedia, Public domain, via Wikimedia Commons